AbstractDoxepin was evaluated in a group of 10 patients for its efficacy in decreasing withdrawal symptoms during ambulatory heroin withdrawal. Although no subjective relief was reported by the subjects, during the 10 days trial, four of the patients developed full blown delirium during the trial's first three days. Since delirium is rarely one of the complications of heroin withdrawal the question whether doxepin enhanced or induced its appearance in these patients, remains unanswered.Until this issue is resolved we suggest cessation of doxepin usage in the initial withdrawal phase from heroin.
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